Health promotion

Health promotion has been defined by the World Health Organization's (WHO) 2005 Bangkok Charter for Health Promotion in a Globalized World as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health".[1] The primary means of health promotion occur through developing healthy public policy that addresses the prerequisites of health such as income, housing, food security, employment, and quality working conditions. More recent work has used the term Health in All Policies to refer to the actions to incorporate health into all public policies. There is a tendency among public health officials and governments—and this is especially the case in neoliberal nations such as Canada and the USA—to reduce health promotion to health education and social marketing focused on changing behavioral risk factors.[2]

Recent work in the UK (Delphi consultation exercise due to be published late 2009 by Royal Society of Public Health and the National Social Marketing Centre) on relationship between health promotion and social marketing has highlighted and reinforce the potential integrative nature of the approaches. While an independent review (NCC 'It's Our Health!' 2006) identified that some social marketing has in past adopted a narrow or limited approach, the UK has increasingly taken a lead in the discussion and developed a much more integrative and strategic approach[3] which adopts a holistic approach, integrating the learning from effective health promotion approaches with relevant learning from social marketing and other disciplines. A key finding from the Delphi consultation was the need to avoid unnecessary and arbitrary 'methods wars' and instead focus on the issue of 'utility' and harnessing the potential of learning from multiple disciplines and sources. Such an approach is arguably how health promotion has developed over the years pulling in learning from different sectors and disciplines to enhance and develop.

History

The "first and best known" definition of health promotion, promulgated by the American Journal of Health Promotion since at least year 1986, is "the science and art of helping people change their lifestyle to move toward a state of optimal health".[4][5] This definition was derived from the 1974 Lalonde report from the Government of Canada,[4] which contained a health promotion strategy "aimed at informing, influencing and assisting both individuals and organizations so that they will accept more responsibility and be more active in matters affecting mental and physical health".[6] Another predecessor of the definition was the 1979 Healthy People report of the Surgeon General of the United States,[4] which noted that health promotion "seeks the development of community and individual measures which can help... [people] to develop lifestyles that can maintain and enhance the state of well-being".[7]

At least two publications led to a "broad empowerment/environmental" definition of health promotion in the mid-1980s:[4]

The WHO, in collaboration with other organizations, has subsequently co-sponsored international conferences on health promotion as follows:

Workplace health promotion

Work site health focus on the prevention and the intervention that reduce the health risks of the employee. The U.S. Public Health Service recently issued a report titled "Physical Activity and Health: A Report of the Surgeon General" which provides a comprehensive review of the available scientific evidence about the relationship between physical activity and an individual's health status. The report shows that over 60% of Americans are not regularly active and that 25% are not active at all. There is very strong evidence linking physical activity to numerous health improvements. Health promotion can be performed in various locations. Among the settings that have received special attention are the community, health care facilities, schools, and worksites.[11] Worksite health promotion, also known by terms such as "workplace health promotion," has been defined as "the combined efforts of employers, employees and society to improve the health and well-being of people at work".[12][13] WHO states that the workplace "has been established as one of the priority settings for health promotion into the 21st century" because it influences "physical, mental, economic and social well-being" and "offers an ideal setting and infrastructure to support the promotion of health of a large audience".[14]

Worksite health promotion programs (also called "workplace health promotion programs," "worksite wellness programs," or "workplace wellness programs") include exercise, nutrition, smoking cessation and stress management. Reviews and meta-analyses published between 2005 and 2008 that examined the scientific literature on worksite health promotion programs include the following:

Health promotion entities and projects by country

Worldwide, government agencies (such as health departments) and non-governmental organizations have substantial efforts in the area of health promotion. Some of these entities and projects are:

International and multinational

The WHO and its Regional Offices such as the Pan American Health Organization are influential in health promotion around the world.[21] The main eight health promotion campaigns marked by WHO are World Health Day, World Tuberculosis Day, World Blood Donor Day, World Immunization Week, World Malaria Day, World No Tobacco Day, World Hepatitis Day and World AIDS Day.[22]

The International Union for Health Promotion and Education, based in France, holds international, regional, and national conferences.[23][24]

Australia

The Australian Health Promotion Association, a professional body, was incorporated in year 1988.[25] In November 2008, the National Health and Hospitals Reform Commission released a paper recommending a national health promotion agency.[26] ACT Health of the Australian Capital Territory supports health promotion with funding and information dissemination.[27] The Victorian Health Promotion Foundation (VicHealth) from the state of Victoria is "the world’s first health promotion foundation to be funded by a tax on tobacco. ".[28] The Australian Government has come up with some initiatives to help Australians achieve a healthy lifestyle.[29] These initiatives are:

Health Promotion is strong and well-established in Australia. Since 2008 there has been a number of graduate courses people can take to be involved within Health Promotion in Australia. The government since 2008 has included an initiative that involves the Aboriginal and Torres Strait Island citizens in the preventive health sector.[34]

Health Promotion In Australian Schools

School programs are based on curriculum documents from state and territory councils. Schools mainly focus on health issues that are being supported by funding and special events. Funding for many health issues are the main basis for school curriculum's health subject.[35]

Health Promotion for Aboriginal and Torres Strait Islander Citizens

Aboriginal and Torres Strait Island citizens in Australia in the last couple of centuries have had poor health. The reason behind the poor health conditions is due to major events in the history of Australia, There is an increasing advancement in the promotion of health for Torres Strait Islander and Aboriginal citizens, but this cannot be achieved without the co-operation of non-indigenous Australians. For this Health promotion to be a success the citizens of Australia need to put the history between non-indigenous and indigenous citizens behind them and co-operate as equals.[36]

Canada

The province of Ontario appointed a health promotion minister to lead its Ministry of Health Promotion in year 2005.[37]

The Ministry’s vision is to enable Ontarians to lead healthy, active lives and make the province a healthy, prosperous place to live, work, play, learn and visit. Ministry of Health Promotion sees that its fundamental goals are to promote and encourage Ontarians to make healthier choices at all ages and stages of life, to create healthy and supportive environments, lead the development of healthy public policy, and assist with embedding behaviours that promote health.[38]

The Canadian Health Network was a "reliable, non-commercial source of online information about how to stay healthy and prevent disease" that was discontinued in 2007.[39]

The BC Coalition for Health Promotion is "a grassroots, voluntary non-profit society dedicated to the advancement of health promotion in British Columbia".[40]

New Zealand

The Health Promotion Forum (HPF) of New Zealand is the national umbrella organization of over 150 organisations committed to improving health.[41][42] HPF has worked with The Cancer Society in order to produce a personal development plan for health promoters, which may be helpful to inform personal development reviews, to identify the competencies of individuals and to provide ideas for future development.[43]

The Health Promotion Agency (HPA), formed July 1, 2012, is a Crown institution that has been established under the New Zealand Public Health and Disability Amendment Act 2012. It's Board has been appointed by the Minister of Health.[44] The work of HPA is divided into three main areas:

HPA has a variety of programs based around many areas of work, including alcohol, immunisation, mental health, and skin cancer prevention. The agency aims to promote the wellbeing of individuals and encourage healthy lifestyles, prevent disease, illness and injury, enable environments that support health and wellbeing, and to reduce personal, economic and social harm.[46]

Health Workforce New Zealand (HWNZ) is an organisation that is part of the National Health Board which provides national leadership on the development of the health workforce.[47] Some health promotional programs supported by HWNZ include education and training initiatives, and the Voluntary Bonding Scheme, which rewards medical, midwifery and nursing graduates who agree to work in hard-to-staff communities, and sonography, medical physicist and radiation therapy graduates who stay in New Zealand.[48]

Health promotion in New Zealand has become an established approach in addressing public problems since the 1980's, through increasing use of intersectoral action, the use of public policy and mass media as promotional strategies, and the increasing control Maori have taken over the provision and purchase of health promotion services.[49] An example of health promotional initiatives is the action put in place to reduce childhood obesity in primary schools. Research was completed to identify the barriers to improving school food environments and promoting healthy nutrition in primary schools in New Zealand.[50]

Considerable progress has also been made in the health impact assessment (HIA) research on the impact of policies on health in New Zealand. The approach has an important contribution to make in the strengthening of health and wellbeing in policymaking in New Zealand[51]

Norway

The Research Centre for Health Promotion and Resources HiST/NTNU (http://www.rchpr.org) was established in Trondheim in 2010. The Centre, led by Professor Geir Arild Espnes, takes part in the scientific exploration of what promotes, maintains and restores good health – both in healthy, vulnerable and diseased populations. The research group has a bio-psycho-social- existential health understanding. Health is understood as a positive resource which every person has more or less of. The Centre will contribute to new knowledge about the following:Factors that promote, sustain, and restore good health in healthy people, vulnerable or exposed groups, and those with health deficiencies.Factors that promote health (i.e., salutogenesis) as opposed to focusing on factors that generate illness and disease (i.e., pathogenesis).

Sri Lanka

Health promotion in Sri Lanka has been very successful during recent decades as shown by the health indicators. Despite the numerous successes over the years, the integrity of the health system has been subjected to many challenges. Sri Lanka is already facing emerging challenges due to demographic, epidemiological, technological and socio-economic transitions. The disease burden has started to shift rapidly towards lifestyle and environmental related non-communicable diseases. These are chronic and high cost and will cause more and perhaps unaffordable burden to the country’s health care expenditure, under the free of charge health services policy. The previous success of health development increased the life expectancy of Sri Lankan people to 72 for male and 76 for women but the estimated “healthy life expectancy” at birth of all Sri Lanka population is only 61.6

Health is affected by biological, psychological, chemical, physical, social, cultural and economic factors in people’s normal living environments and lifestyles. With the current rapid changing demographic, social and economic context and the epidemiological pattern of diseases, the previous health promotion interventions which found to be effective in the past may not be effective enough now and the future to address all the important determinants that affect health. Promoting people’s health must be the joint responsibility of all the social actors. These challenges require significant changes in the national health system toward new effective health promotion which has been accepted worldwide as the most cost effective measure to reduce the disease burden of the people and the burden of the nation on the increasing cost for treatment of diseases.

The development of this National Health Promotion Policy is based on: (a) the evidences from Sri Lanka health promotion situation analysis, (b) the international accepted concept, the WHO guiding principle for health promotion and the World Health Assembly resolutions and WHO South East Asia Regional Committee Resolution, and (c) the State Policy and Strategy for Health and the Health Master Plan 2007–2016.

The key strategies for health promotion are: advocacy and mediate between different interests in society for the pursuit of health; empower and enable individual and communities to take control over their own health and all determinants of health; improve the health promotion management, health promotion interventions, programs, plans and implementation; and partnership, networking, alliance building and integration of health promotion activities across sectors.


In Sri Lanka, other non health government sectors and NGOs are currently active implementing their community development projects with the community empowerment concept that resemble the healthy setting approach for health promotion. These projects are the high potential entry points and good opportunity for the formal commencement of the new effective setting approach health promotion and the holistic life course health promotion. It is also an opportunity for partnerships and alliance building for concerted action to promote health of the nation. This policy is formulated to promote health and well-being of the people by enabling all people to be responsible for their own health and address the broad determinants of health through the concerted actions of health and all other sectors to make Sri Lanka a Health Promoting Nation where all the citizens actively participate in health promotion activities continuously for a healthy life expectancy.

The policy objectives are as follow :

  1. To strengthen leaderships for health promotion at all levels and all sectors through advocacy.
  2. To mobilize the society and create nationwide health promotion actions.
  3. To develop and implement effective comprehensive holistic and multisectoral approach health promotion interventions.
  4. To establish an effective system and mechanism for health promotion management and coordination at all levels.
  5. To build capacity for health promotion at all levels and across sectors.
  6. To improve financing and resources allocation and utilization for health promotion.
  7. To establish an evidence-base for health promotion effectiveness.

Various strategies have been developed for the attainment of each objective focus on the multi-sectoral comprehensive approach and participation of all stakeholders and the people themselves. This National Health Promotion Policy will be monitored and evaluated at all levels. Participatory monitoring and evaluation will be encouraged at implementation level.The National Health Promotion Consortium and the National Health Council will be responsible for the regular monitoring and evaluation of the implementation of this National Health Promotion Policy. Implementation of this policy will also be monitored regularly as part of the overall process of monitoring the activities of the Government and Ministries and covering various sectors and levels of government.

United Kingdom

The Royal Society for Public Health was formed in October 2008 by the merger of the Royal Society for the Promotion of Health (also known as the Royal Society of Health or RSH) and the Royal Institute of Public Health (RIPH). Earlier, July 2005 saw the publication by the Department of Health and Welsh Assembly Government of Shaping the Future of Public Health: Promoting Health in the NHS. Following discussions with the Department of Health and Welsh Assembly Government officials, the Royal Society for Public Health and three national public health bodies agreed, in 2006, to work together to take forward the report's recommendations, working in partnership with other organisations. Accordingly:

  1. the Royal Society for Public Health (RSPH) leads and hosts the collaboration, and focuses on advocacy for health promotion and its workforce;
  2. The Institute of Health Promotion and Education (IHPE) works with the RSPH Royal Society for Public Health to give a voice to the workforce;
  3. the Faculty of Public Health (FPH) focuses on professional standards, education and training; and
  4. (4) the UK Public Health Register (UKPHR) is responsible for regulation of the workforce.

In Northern Ireland, the government's Health Promotion Agency for Northern Ireland which was set up to "provide leadership, strategic direction and support, where possible, to all those involved in promoting health in Northern Ireland". The Health Promotion Agency for Northern Ireland was incorporated into the Public Health Agency for Northern Ireland in April 2009.[52]

United States

Government agencies in the U.S. concerned with health promotion include the following:

Nongovernmental organizations in the U.S. concerned with health promotion include:

See also

References

  1. ↑ Participants at the 6th Global Conference on Health Promotion. The Bangkok Charter for health promotion in a globalized world. Geneva, Switzerland: World Health Organization, 2005 Aug 11. Accessed 2009 Feb 4.
  2. ↑ Bunton R, Macdonald G. (2002). Health promotion: disciplines, diversity, and developments (2nd ed.). Routledge. ISBN 0-415-23569-3.
  3. ↑ Strategic Social Marketing in 'Social Marketing and Public Health' 2009 Oxford Press
  4. ↑ 4.0 4.1 4.2 4.3 4.4 Minkler M (Spring 1989). "Health education, health promotion and the open society: an historical perspective". Health Educ Q 16 (1): 17–30. doi:10.1177/109019818901600105. PMID 2649456.
  5. ↑ American Journal of Health Promotion. Accessed 2009 Feb 4.
  6. ↑ Lalonde M. A new perspective on the health of Canadians. A working document. Ottawa: Government of Canada, 1974.
  7. ↑ Healthy people: the Surgeon General's report on health promotion and disease prevention. Washington, DC: U.S. Department of Health, Education, and Welfare, Public Health Service, Office of the Assistant Secretary for Health and Surgeon General, 1979. DHEW (PHS) Publication No. 79-55071. Accessed 2009 Feb 4.
  8. ↑ 8.0 8.1 "A discussion document on the concept and principles of health promotion" (PDF). Health Promot 1 (1): 73–6. May 1986. doi:10.1093/heapro/1.1.73. PMID 10286854.
  9. ↑ 9.0 9.1 Epp J (1986). "Achieving health for all. A framework for health promotion" (PDF). Health Promot 1 (4): 419–28. doi:10.1093/heapro/1.4.419. PMID 10302169.
  10. ↑ 10.0 10.1 The Ottawa Charter for Health Promotion. First International Conference on Health Promotion, Ottawa, 21 November 1986. Accessed 2009 Feb 4.
  11. ↑ Tones K, Tilford S (2001). Health promotion: effectiveness, efficiency and equity (3rd ed.). Cheltenham UK: Nelson Thornes. ISBN 0-7487-4527-0.
  12. ↑ European Network for Workplace Health Promotion. Workplace health promotion. Accessed 2009 Feb 4.
  13. ↑ World Health Organization. Workplace health promotion. Benefits. Accessed 2009 Feb 4.
  14. ↑ World Health Organization. Workplace health promotion. The workplace: a priority setting for health promotion. Accessed 2009 Feb 4.
  15. ↑ Engbers LH, van Poppel MN, Chin A Paw MJ, van Mechelen W (July 2005). "Worksite health promotion programs with environmental changes: a systematic review". Am J Prev Med 29 (1): 61–70. doi:10.1016/j.amepre.2005.03.001. PMID 15958254.
  16. ↑ Pelletier KR (October 2005). "A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: update VI 2000–2004". J. Occup. Environ. Med. 47 (10): 1051–8. doi:10.1097/01.jom.0000174303.85442.bf. PMID 16217246.
  17. ↑ Chapman LS (2005). "Meta-evaluation of worksite health promotion economic return studies: 2005 update" (PDF). Am J Health Promot 19 (6): 1–11. PMID 16022209.
  18. ↑ Kuoppala J, Lamminpää A, Husman P (November 2008). "Work health promotion, job well-being, and sickness absences—a systematic review and meta-analysis". J. Occup. Environ. Med. 50 (11): 1216–27. doi:10.1097/JOM.0b013e31818dbf92. PMID 19001948.
  19. ↑ Martin A, Sanderson K, Cocker F (January 2009). "Meta-analysis of the effects of health promotion intervention in the workplace on depression and anxiety symptoms". Scand J Work Environ Health 35 (1): 7–18. doi:10.5271/sjweh.1295. PMID 19065280.
  20. ↑ Goetzel RZ, Ozminkowski RJ (2008). "The health and cost benefits of work site health-promotion programs". Annu Rev Public Health 29: 303–23. doi:10.1146/annurev.publhealth.29.020907.090930. PMID 18173386.
  21. ↑ Kickbusch I (March 2003). "The contribution of the World Health Organization to a new public health and health promotion" (PDF). Am J Public Health 93 (3): 383–8. doi:10.2105/ajph.93.3.383. PMC 1447748. PMID 12604477.
  22. ↑ World Health Organization, WHO campaigns.
  23. ↑ International Union for Health Promotion and Education. Accessed 2009 Feb 4.
  24. ↑ Cheung, Robin. Overall health and wellbeing deserves more than lip service. South China Morning Post 2007 Jul 7.
  25. ↑ Australian Health Promotion Association. Providing knowledge, resources and perspective. Accessed 2009 Feb 4.
  26. ↑ Cresswell, Adam. Plan for agency to prevent illness. The Australian 2008 Nov 7. Accessed 2009 Feb 4.
  27. ↑ ACT Health Promotion. Online support for health promotion workers in the ACT. Accessed 2009 Feb 4.
  28. ↑ About VicHealth. Accessed 2009 Feb 4.
  29. ↑ "Healthy Active". A Healthy and Active Australia. Department of Health. 18 February 2015. Retrieved 7 April 2015.
  30. ↑ Health, Department of (2 April 2009). "Health Active". Get Set for Life - Habits for Healthy Kids. Australian Government. Retrieved 7 April 2015.
  31. ↑ Health, Department of (8 August 2014). "Healthy Active". Stephanie Alexander Kitchen Garden National Program. Australian Government. Retrieved 7 April 2015.
  32. ↑ "Kitchen Garden Foundation". Kitchen Garden Foundation. Australian Government. Retrieved 7 April 2015.
  33. ↑ Health, Department of (12 August 2009). "Healthy Active". Healthy Spaces and Places. Australian Government. Retrieved 7 April 2015.
  34. ↑ Wise, Marilyn (19 November 2008). "Health Promotion in Australia". Reviewing the past and looking to the future. doi:10.1080/09581590802503068. Retrieved 7 April 2015.
  35. ↑ Marshall, BJ (2 March 2012). "School based health promotion across Australia". Journal of School Health. doi:10.1111/j.1746-1561.2000.tb07430.x.
  36. ↑ Angus, S (1997). "Global Health Promotion" (PDF). Promoting the Health of Aboriginal and Torres Strait Island People: Issues for the Future. doi:10.1177/102538239700400313. Retrieved 7 April 2015.
  37. ↑ Benzie, Robert. Obesity now on Ontario hit list — Health promotion minister's new job. Toronto Star 2005 Jul 14.
  38. ↑ Ministry of Health Promotion Results-Based Plan 2009-10
  39. ↑ Goar C. Conservatives axe health network. Toronto Star 2007 Nov 16. Accessed 2009 Feb 4.
  40. ↑ BC Coalition for Health Promotion. Who we are. Accessed 2009 Feb 4.
  41. ↑ Health Promotion Forum of New Zealand. Accessed 2009 Feb 4.
  42. ↑ Wise M, Signal L. (2000). "Health promotion development in Australia and New Zealand". Health Promot Int 15 (3): 237–248. doi:10.1093/heapro/15.3.237.
  43. ↑ Health Promotion Forum of New Zealand (2014). "HP Competencies". Health Promotion Forum of New Zealand. Retrieved 16/04/15. Check date values in: |accessdate= (help)
  44. ↑ "Who we are | HPA - Health promotion agency". www.hpa.org.nz. Retrieved 2015-04-16.
  45. ↑ "How we work | HPA - Health promotion agency". www.hpa.org.nz. Retrieved 2015-04-16.
  46. ↑ "What we do | HPA - Health promotion agency". www.hpa.org.nz. Retrieved 2015-04-16.
  47. ↑ "Home | Health Workforce NZ". healthworkforce.health.govt.nz. Retrieved 2015-04-16.
  48. ↑ New Zealand Ministry of Health (3 February 2015). "Health Workforce New Zealand". New Zealand Ministry of Health. Retrieved 16/04/15. Check date values in: |accessdate= (help)
  49. ↑ Wise, Marilyn; Signal, Louise (2000). "Health promotion development in Australia and New Zealand". Health Promotion International. doi:10.1093/heapro/15.3.237. Retrieved 16/04/15. Check date values in: |accessdate= (help)
  50. ↑ Walton, Mat; Waiti, Jordan; Signal, Louise; Thomson, George (03/01/2010). "Identifying barriers to promoting healthy nutrition in New Zealand primary schools". Health Education Journal 69 (1): 84–94. doi:10.1177/0017896910363152. ISSN 0017-8969. Retrieved 2015-04-16. Check date values in: |date= (help)
  51. ↑ Singal, Louise; Langford, Barbara; Quigley, Rob; Ward, Martin (2006). "Strengthening health, wellbeing and equity: Embedding policy-level HIA in New Zealand" (PDF). Social Policy Journal of New Zealand. Retrieved 16/04/15. Check date values in: |accessdate= (help)
  52. ↑ Public Health Agency for Northern Ireland HSC About Us (accessed 23 January 2012)
  53. ↑ Smith, Sandy. The CDC reorganization and its impact on NIOSH. EHS Today 2004 May 28. Accessed 2009 Feb 4.
  54. ↑ Centers for Disease Control and Prevention. About CDC’s Coordinating Center for Health Promotion. 2008 Jul 2. Accessed 2009 Feb 4.
  55. ↑ The National Institute for Occupational Safety and Health. What is Total Worker Health? Accessed 2012 Oct 25.
  56. ↑ U.S. Army Center for Health Promotion and Preventive Medicine. About USACHPPM. Accessed 2009 Feb 4.
  57. ↑ McQueen DV, Kickbusch I (2007). Health and modernity: the role of theory in health promotion. New York: Springer. p. 15. ISBN 978-0-387-37757-5.
  58. ↑ Wellness Council of America. WELCOA overview. Accessed 2009 Feb 4.
  59. ↑ Hobart honored as state's first "well city." Wellness Council of America honors city for promoting safe workplaces. Post-Tribune (IN) 2000 Oct 16.
  60. ↑ URAC announces accreditation standards for Comprehensive Wellness programs. Washington, D.C.: URAC, 2008 Nov 19. At Accessed 2009 Feb 4.

Further reading

External links